Congress is set to ban most surprise medical bills • Hacker News Board

Re: Congress is set to ban most surprise medical bills

#211

Post by uoaei » Mon, Dec 21, 2020, 6:41 PM UTC

cpuguy83 wrote: post #61

jsperson wrote: post #48

Earlier quoted context omitted.

> The existing health insurance industry is far from free market. Try getting a price for a procedure or visit beforehand. Oh, I know. I've tried getting prices in the past. Traditional providers can't do it. One thing that has opened my eyes is using a Direct Primary Care (DPC) provider. I pay $75 a month for direct access to my doctor (email, text message, cell phone etc.). The access is great, but an unexpected si…

The annoying thing is, most people would agree that the whole system sucks... until you start talking about politics and suddenly you'd think a bunch of people have a love affair with their insurance company and healthcare providers.

> until you start listening to politicians who have a vested interest in making the general public believe such things

FTFY

People "love their health insurance" when they have it forever through their employment, and feel safe in their position.

80% of people in the US, including 50% of Republicans, support M4A precisely because they are not part of the upper-crust minority who are afforded such luxuries.

Re: Congress is set to ban most surprise medical bills

#212

Post by phkahler » Mon, Dec 21, 2020, 6:42 PM UTC

iaw wrote: post #100

jsperson wrote: post #13

That it takes such effort to pass a bill like this - 80% public approval, banning a clearly predatory practice, has turned me from a pure free market thinking into a believer in single payer healthcare. The free market just doesn't work when there is very little elasticity in consumption. I've been on the receiving end of a $15K air ambulance bill (thankfully covered by insurance) as well as the out of network specia…

> has turned me from a pure free market thinking into a believer in single payer healthcare The current trend in 'free-market economics' is to call captured markets free and then argue for the relatively lax regulation. Most markets are not free markets and the healthcare definitely isn't. There's very little true choice, participants are typically under duress when seeking expensive services, and prices are hidden.…

>> If there was ala-carte transparent pricing and no insurer lockouts things may be a bit better.

Posted prices, and provider always charges that price weather its paid by insurance or not. Then insurance companies can compete on how much they cover at what premiums.

Re: Congress is set to ban most surprise medical bills

#213

Post by curtainsforus » Mon, Dec 21, 2020, 6:43 PM UTC

lvs wrote: post #200

gregario wrote: post #192

Earlier quoted context omitted.

It's the regulations / limitations you are proposing that make it possible/likely that a monopoly will form. See Milton Friedman on this. There's basically no example of a monopoly forming outside of government regulation.

That is a completely bizarre claim. What is Google? A highly regulated search monopoly? I think not.

DMCA

Re: Congress is set to ban most surprise medical bills

#214

Post by cogman10 » Mon, Dec 21, 2020, 6:43 PM UTC

devonbleak wrote: post #165

annexrichmond wrote: post #118

Earlier quoted context omitted.

> and prices are hidden I believe the Trump administration is addressing this: https://www.hhs.gov/about/news/2019/11/15/trump-administrati... https://www.hhs.gov/about/news/2020/10/29/trump-administrati... > The rule requires that most health plans and health insurers not only provide easy-to-understand personalized information on enrollee cost-sharing for healthcare services, but must also publicly disclose the rat…

This doesn't even begin to address the real problem: emergency care. Sure I can shop around and do a bunch of research for something that I know is coming up, but when the out of network specialist drops into my wife's hospital room as she's having an asthma attack and can't breathe I don't have the temporal luxury of vetting how much that particular specialist is going to cost out of pocket and can I please have one…

I worry that it will lead to much worse treatment on top of that.

Even if it's a non-emergency, getting the prices up front will cause a lot of people to chose to either go untreated or to delay treatment until a problem becomes far worse.

Just having prices available does nothing to improve the costs. People with type 1 diabetes know the cost of insulin. Has that prevented it's price from moving to levels that many can't afford?

It doesn't matter if the costs are known up front when drug manufactures end up with patent help that allows them to gouge. When medical devices are often produced by very few manufactures. When hospitals enjoy local monopolies.

The thought that the only thing missing from keeping medical prices down is the price tag is just absurd.

Re: Congress is set to ban most surprise medical bills

#215

Post by clownbaby » Mon, Dec 21, 2020, 6:45 PM UTC

c22 wrote: post #90

OkGoDoIt wrote: post #56

Earlier quoted context omitted.

Is this a snarky comment or is this an actual experience that’s happened to you or someone you know? I’m genuinely curious, I can definitely imagine hospitals trying something like this…

I've never "interrogated" a medical professional about their in or out of network status, so I have no first hand knowledge. But I have been charged their ridiculous hourly rates for 5-10 minute "consultations" so I have no reason to believe they wouldn't charge you for this.

My wife was charged $65 "to meet the surgeon" that would be performing procedure if she went ahead with it (she didn't ask to meet him, btw). It was basically just "Hey Bill, can you come over here and say hi to this patient". She had the charges waived pretty easily, but, if you don't call and ask and/or complain, those charges stand.

Re: Congress is set to ban most surprise medical bills

#216

Post by schoolornot » Mon, Dec 21, 2020, 6:47 PM UTC

bfieidhbrjr wrote: post #57

jsperson wrote: post #13

That it takes such effort to pass a bill like this - 80% public approval, banning a clearly predatory practice, has turned me from a pure free market thinking into a believer in single payer healthcare. The free market just doesn't work when there is very little elasticity in consumption. I've been on the receiving end of a $15K air ambulance bill (thankfully covered by insurance) as well as the out of network specia…

There's no "market" in healthcare in the US. Long ago, it became illegal to open a hospital without a 'certificate of need' from the State. That's why so many towns have only one hospital - it's a government granted monopoly like cable companies in the 80s. Differential pricing is also illegal. You fly cheap on Sunday at 3am, expensive on Monday at 9am. Healthcare providers are not allowed to charge less when it's ch…

Are most of the costs even accumulated in hospitals? I'd imagine the price gouging certainly is. We arbitrarily restrict the number of MD students so why shouldn't we expect $1000/hr. bills for care?

Re: Congress is set to ban most surprise medical bills

#217

Post by vkou » Mon, Dec 21, 2020, 6:47 PM UTC

phkahler wrote: post #212

iaw wrote: post #100

Earlier quoted context omitted.

> has turned me from a pure free market thinking into a believer in single payer healthcare The current trend in 'free-market economics' is to call captured markets free and then argue for the relatively lax regulation. Most markets are not free markets and the healthcare definitely isn't. There's very little true choice, participants are typically under duress when seeking expensive services, and prices are hidden.…

>> If there was ala-carte transparent pricing and no insurer lockouts things may be a bit better. Posted prices, and provider always charges that price weather its paid by insurance or not. Then insurance companies can compete on how much they cover at what premiums.

That leaves too much patient money on the table, and will lead to patients doing comparison shopping, which is not something the healthcare industry wants.

Re: Congress is set to ban most surprise medical bills

#218

Post by AnthonyMouse » Mon, Dec 21, 2020, 6:48 PM UTC

lvs wrote: post #200

gregario wrote: post #192

Earlier quoted context omitted.

It's the regulations / limitations you are proposing that make it possible/likely that a monopoly will form. See Milton Friedman on this. There's basically no example of a monopoly forming outside of government regulation.

That is a completely bizarre claim. What is Google? A highly regulated search monopoly? I think not.

There are actually quite a lot of government regulations without which a search monopoly would be less likely, from the patents Google holds to the CFAA creating uncertainty for small competitors to do the scraping that would be necessary to get as comprehensive an index without being large enough to have sites request indexing to the GDPR increasing compliance costs to the RIAA/MPAA and news sites flinging lawsuits left and right based on overbroad copyright laws to the FCC rules that impair last mile competition that could result in higher upload speeds and thereby greater P2P content hosting which is more easily indexed by search competitors.

Re: Congress is set to ban most surprise medical bills

#219

Post by akiselev » Mon, Dec 21, 2020, 6:48 PM UTC

gregario wrote: post #192

kstrauser wrote: post #168

Earlier quoted context omitted.

I've that this before, but I like my markets free as in GPL, not free as in BSD. That is, I want the markets themselves to be free, even if that means that participants in the market have limitations put on them to keep them from capturing the market, forming monopolies, etc.

It's the regulations / limitations you are proposing that make it possible/likely that a monopoly will form. See Milton Friedman on this. There's basically no example of a monopoly forming outside of government regulation.

> There's basically no example of a monopoly forming outside of government regulation.

That's tautological statement. There is no free market without private property protections which do not exist outside of government regulation either.

Re: Congress is set to ban most surprise medical bills

#220

Post by javajosh » Mon, Dec 21, 2020, 6:49 PM UTC

iaw wrote: post #100

jsperson wrote: post #13

That it takes such effort to pass a bill like this - 80% public approval, banning a clearly predatory practice, has turned me from a pure free market thinking into a believer in single payer healthcare. The free market just doesn't work when there is very little elasticity in consumption. I've been on the receiving end of a $15K air ambulance bill (thankfully covered by insurance) as well as the out of network specia…

> has turned me from a pure free market thinking into a believer in single payer healthcare The current trend in 'free-market economics' is to call captured markets free and then argue for the relatively lax regulation. Most markets are not free markets and the healthcare definitely isn't. There's very little true choice, participants are typically under duress when seeking expensive services, and prices are hidden.…

Yes, it should be "free markets...until the wolves take over the whole system". It's impressive how quickly those profit maximization ideas have caught on, driven by technology (I blame Excel more than anything), and throughout the entire system. The healthcare cash-cow benefits a LOT of people, workers, suppliers, and (especially) administrators at both hospitals and doctors offices. A poor healthcare system is a great way to create BS jobs, and have a de facto welfare system while not actually legislating for it.

It is remarkable how quickly and completely the noble ideals of the professions (medicine and law) have totally fallen to the profit motive. Now, you are a fool if you show self-restraint, because no one will notice, and your unscrupulous competitors will eat your lunch. It's the kind of pervasive corruption that can only happen when literally everyone in the system, including the victims, have given up.